Towards improving prehospital triage for older trauma patients
- 28.01.2021
- Themenschwerpunkt
Erschienen in:
- Verfasst von
- Abdullah Alshibani
- Boris Singler
- Simon Conroy
- Erschienen in
- Zeitschrift für Gerontologie und Geriatrie | Ausgabe 2/2021
Abstract
Background
The proportion of older adults with major trauma is increasing. High-quality care for this population requires accurate and effective prehospital trauma triage decisions.
Objective
Anatomical and physiological changes with age, comorbidities, and medication use for older adults may affect the accuracy of prehospital trauma triage.
Material and methods
This narrative review focusses on age-related anatomical and physiological changes, comorbidities, and medication use for older adults with an emphasis on their impact on the accuracy of prehospital trauma triage tools. It also addresses the efforts to develop alternative triage criteria to reduce undertriage.
Results
Age-related anatomical and physiological changes, comorbidities, and medication use were shown to affect physiological responses to injury and mechanism of injury for older people. Current triage tools poorly predicted injury severity. Geriatric-specific physiological measures and comorbidities significantly improved sensitivity with much lower specificity. Assessing anticoagulant or antiplatelet use in head injury notably improved sensitivity to identify traumatic intracranial hemorrhage, neurosurgery or death with modest decrease in specificity.
Conclusion
Improving prehospital providers’ knowledge about the challenges of assessing older people with trauma may reduce undertriage. Assessing frailty could help in improving prehospital providers’ judgments. Future research is needed to improve triage decisions for this population.
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- Titel
- Towards improving prehospital triage for older trauma patients
- Verfasst von
-
Abdullah Alshibani
Boris Singler
Simon Conroy
- Publikationsdatum
- 28.01.2021
- Verlag
- Springer Medizin
- Erschienen in
-
Zeitschrift für Gerontologie und Geriatrie / Ausgabe 2/2021
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269 - DOI
- https://doi.org/10.1007/s00391-021-01844-4
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